On May 12, 2015, a northbound Amtrak train derailed outside of Philadelphia, killing eight people and injuring more than 200. Anne Klimke, MD, MS, FACEP, was heading to her shift at Einstein Medical Center in Philadelphia when she learned of the accident and that trauma patients would soon be arriving at her emergency department.

Dr. Klimke
Photo courtesy of Wesley Hilton

recently sat down with ACEP Now Medical Editor-in-Chief Kevin Klauer, DO, EJD, FACEP, to talk about the experience of caring for those hurt in the crash and how her disaster medicine training and experience with the FEMA Urban Search and Rescue group equipped her to deal with the volume of patients and the rapid triage needed to care for the injured.

Dr. Kevin Klauer: Tell me about your training background.

Dr. Anne Klimke: I started at Einstein in 2005, and I did the four-year residency program there in emergency medicine. I was really lucky to be able to do a combined residency and fellowship in emergency medical services (EMS) and disaster medicine. In five years, I came out with a master’s degree in disaster management from Philadelphia University.

KK: What ere you doing when you were notified that there might be a disaster?

AK: I had just gotten into my car to drive in for my 11 p.m.–7 a.m. shift when I got a phone call from one of my colleagues, Ryan Overberger. He said, “There was a train derailment at Aramingo.” There was definitely a lot of adrenaline and mental coaching for myself on the way in. I was thinking, “OK, what’s the mechanism of injury? What kinds of injuries do I anticipate? We should probably call the other portable tech for radiology to come down from doing in-patient films so that we have the two portable machines down there. We should make sure that we have enough supplies for casting. We have a cart-based system, so we should pull all the carts up into A Pod and let central supply know that we may be calling them for more. Am I going to see neurosurgical cases?” The trauma attending called in the neurosurgeon just because brain injury is highly likely with a train crash.

When I got to the ED, my colleagues were already in the midst of trying to decompress the emergency department and get all of the admitted patients out. They made the phone calls to notify trauma, anesthesia, orthopedics, and neurosurgery. We were definitely ramping up to receive lots of trauma patients.